Tiny Tips | SVNCOPE for Syncope

In Tiny Tips by Jared PatyLeave a Comment

Syncope is common presenting complaint in the emergency department. Over 40% of adults will experience a syncopal episode, and syncope accounts for approximately 1% of all ED visits (1). Because syncope can result from a variety of etiologies, both life-threatening and benign, the syncopal patient is diagnostically challenging and can be especially daunting for learners. A consistent framework helps learners avoid missing a potentially serious underlying problem. The SVNCOPE mnemonic is a useful …

Tiny Tip: HINTS exam to determine INFARCT

In Tiny Tips by Andrew Petrosoniak1 Comment

I recently wrote a post about the utility of the HINTS exam for patients who present with persistent vertigo known as acute vestibular syndrome (AVS). The available evidence suggests that this bedside exam is highly effective to help differentiate peripheral from central causes. And in one study, it may even be better than an MRI in the first 48hrs [1]! Finally, the answer to all of your vertiginous problems in the emergency department…except …

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Tiny Tip | Canadian C-spine Rule Mnemonic

In Tiny Tips by Teresa Chan4 Comments

Clinical Decision Tool uptake In 2007, Dr. Ian Stiell wrote a paper [1] about the uptake and real-life implementation of his four clinical decision rules (or as we prefer to call them, clinical decision tools).  The paper concludes that “Future research should identify implementation barriers and explore strategies to achieve better knowledge uptake in the ED”. The BoringEM team hypothesizes that the ease of use may be greatly affected by the complexity of a rule itself …

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Tiny Tip: Determining capacity in an emergency – The CURVES Mnemonic

In Tiny Tips by Brent ThomaLeave a Comment

Determining capacity in a patient that needs to make an emergency medical decision can be a huge challenge for emergency physicians with substantial legal and patient-oriented consequences. As emergency medicine providers we need to be able to make this determination confidently and decisively. By preparing our approach in advance we can be more confident in our decisions. In November 2014, EM:RAP (check it out!) had a great segment on decision making capacity and …

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Tiny Tip: C BIG K DROP (Management of Hyperkalemia with ECG changes)

In Tiny Tips by Ping Yu Xiong4 Comments

Editors Note: As you know, BoringEM has never shied away from controversy. In this Tiny Tip, we present to you a mnemonic for the management of hyperkalemia with ECG changes – wrought with several interesting suggestions with which MANY will avidly jump to post-publication peer review.  We welcome the opportunity to engage with you and your comments below.  Of note, please stay tuned for the official “debrief” in this discussion on Thursday, September …

Boring Question: Does this medication cause long QT? (with Bonus: Tiny Tips!)

In Clinical Questions, Tiny Tips by Jatin Kaicker7 Comments

The Clinical Case A 70-year-old female presents to the emergency department with new palpitations and 2 syncopal episodes, witnessed by her son. These episodes have started within the past 10 days. Her past medical history includes diabetes, hypertension, depression, dyslipidemia and atrial fibrillation. She is a long-standing diabetic and is followed by a nephrologist for her diabetic nephropathy. Her medications included: metformin, atorvastatin, aspirin, warfarin and sertraline. She was recently seen in hospital …